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- It is a pleasure to open this debate on behalf of His Majesty’s Government, and to have the opportunity to speak about the long-term decisions that the Government have been taking for a healthier future for our country, for our national health service, and for our social care system.We are building our health and care system for today and for tomorrow. We are increasing the capacity of the NHS and social care systems, boosting primary care and community care, investing in diagnostics and in treatments, building our NHS workforce with the long-term workforce plan and building our social care workforce with our 10-year vision, putting people at the heart of care. We are giving people choice and control over their health and care, and investing in the facilities and technology that need to be at the forefront of care and sustainable for the long term. We are driving reforms to prevent ill health, joining up health and care in integrated care systems and delivering a shift towards prevention and proactive care, keeping people out of hospital and enabling them to live independently in their communities.Every day since last winter, we have been planning and preparing for the challenges that lie ahead this winter. The first ever NHS long-term workforce plan underpins our plans for the future of the NHS. It will double the number of medical training places, almost double the number of adult nursing places, and expand GP and allied health professional training numbers, giving the NHS the staff it needs for the future, creating new roles, building new training pathways and delivering a huge boost in diagnostic capacity.By the end of this year, we will have opened 160 new community diagnostic centres. That is the biggest investment in MRI and CT scanning capacity in NHS history. Community diagnostic centres will bring care closer to home, on high streets, in supermarket car parks and at football stadiums. They have already done more than 5 million tests and scans, getting patients faster diagnosis for cancer, heart disease and other life-threatening conditions. That is not all we are doing to diagnose conditions faster. The number of people receiving blood pressure checks at local pharmacies has more than doubled, reducing thousands of people’s risk of suffering a heart attack or stroke.We are expanding primary care, too. There are now over 30,000 more primary care professionals working in GP practices than in March 2019. We will deliver 50 million more GP appointments by the end of next year and we are investing more than £200 million in tech to end the 8 am rush for GP appointments. Pharmacy First will give people another choice, giving pharmacists the power to prescribe treatments for seven common conditions, freeing up as many as 10 million GP appointments, and as we put test results on to the NHS app, that will free up GP time again.That is also one of the ways that this Government are giving patients more choice and control. Just as we are going to give people more choice in where they are treated when they are referred by their GP for specialist care, we have committed to giving patients a choice between by five providers so that they are treated based on what matters to them—be that shorter waiting times, seeing a particular doctor or getting care closer to home. We have given patients who are waiting more than 40 weeks the right to request treatment elsewhere, making better use of available capacity across the NHS and bringing in more capacity from the independent sector.On patient choice, there is a clear dividing line between the Government and the Opposition. The Leader of the Opposition calls the Welsh Government the blueprint for what Labour would do in power, yet in Wales, under a Labour Government, there is no legal right to patient choice, and patients there wait on average five weeks longer for treatment than in England. We know where Labour’s plans would lead. We just need to look at its Welsh blueprint: less choice for patients, longer waiting lists and more bureaucracy for doctors and nurses who just want to get on with the job.Before the most disruptive industrial action in NHS history stalled progress, we were reducing the longest waits. Last summer we hit our target to eliminate two-year waits for planned operations. This June we had virtually eliminated waits longer than 18 months. We are spending more than £8 billion between 2022 and 2025 to increase elective activity, including opening over 140 new surgical hubs to deliver 2 million more operations. We are investing almost £6 billion in beds, equipment and technology, and this year we started preparing the NHS for winter sooner than ever before.Back in January, we published our recovery plan for urgent and emergency care, setting clear targets to improve A&E waiting and ambulance response times and using £1 billion of dedicated funding to provide 5,000 more permanent staff beds and 800 new ambulances. We are seeing results. In October, average category 2 ambulance response times were more than 90 minutes faster than in the same month last year. Delayed discharges have been coming down and we have brought forward flu and covid vaccinations, protecting the most vulnerable from illness this winter and reducing the likelihood that they will need hospital treatment.A strong social care sector is also vital this winter and into the future. That is why we have made up to £8 billion available over this year and next to boost adult social care across the country. This is enabling local authorities to buy more care packages and help more patients to leave hospital on time, together with 10,000 “hospital at home” beds which mean that patients can receive their care where they are most comfortable, recovering in their own homes with support from secondary care when they need it. Through social prescribing, thousands of people up and down the country are benefiting from activities such as reading circles, choir groups, walking and football. We are driving reforms to the intermediate and proactive care framework, which sets out how local systems should support adults who need support after discharge, freeing up hospital capacity for those who need it most and giving people more care as they need it—in their community, away from A&E and out of hospital.We are rolling out technology that will give patients life-saving treatments now and in the future. By the end of the year, every stroke network in England will have AI technology that can examine brain scans an hour faster, cutting stroke patients’ risk of suffering long-term consequences by as much as two thirds. What is more, almost half of NHS acute trusts have won a share of £21 million to invest in AI, accelerating the analysis of X-rays and CT scans for suspected lung cancer patients. That will save radiologists’ time, boost efficiency and cut waiting times. For the long-term, we are investing a further £100 million to use AI to unlock treatments for diseases that are incurable today, be they novel treatments for dementia or vaccines for cancer.
- Can the Minister say something about the availability of new and specialist drugs that the National Institute for Health and Care Excellence is not recommending? Will an effort be made to make these specialist drugs, which in many instances are effectively regarded as miracle cures, available for cystic fibrosis and cancer treatments, for example?
- I understand what the hon. Gentleman is saying, and I know how strongly families and patients feel about this. It is not for me, as a Minister, to step on the independence of NICE, which has a remit to take those decisions. I am sure that the new Secretary of State for Health and Social Care, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), and other Ministers in the Department will continue to listen to the concerns of families about access to those treatments.If we want to fully embrace preventive care, we must tackle the single biggest preventable cause of ill health, disability and death, which is smoking. Unlike drinking alcohol or eating fatty, salty or sugary foods, there is no safe level of smoking. It causes almost one hospital admission every minute, one in four cancer deaths and 64,000 deaths a year.Four in five smokers start by the time they are 20, so the best thing we can do is to stop young people smoking in the first place. That is why this Government will automatically raise the smoking age by one year every year, so anyone who is 14 or younger today will never be able to buy tobacco legally. Increasing the smoking age works. When it rose to 18, smoking rates dropped by almost a third in that age group. Restricting choice is never easy, but this time it is the right thing to do. Existing smokers will not be affected, but the next generation will be smoke-free, saving thousands of lives, reducing pressure on the NHS and building a brighter future for our children.
- I hear what the Minister says about the Government’s commitment to this policy, but can she explain why the Government are allowing a free vote rather than whipping Back Benchers to vote for Government policy?
- I am not going to stand here and explain whipping policy, which is not my job as a Health Minister, but I am delighted to see the potential of this legislation. As with so many other worthwhile Government policies, such as increasing funding for the national health service, I would be delighted to see the right hon. Gentleman and other Opposition Members support this policy.We are also cracking down on the alarming rise in vaping among children. There is no doubt that vaping is safer than smoking and is a terrific tool to help adult smokers quit, but, like Members across the House, I am concerned that one in five children has tried vaping, which can be hugely damaging to their health. The whole House knows that no child should be using nicotine.The rise in youth vaping is no coincidence. Disposable vapes are consistently marketed at children and are available at pocket-money prices, with many retailers ignoring their duty not to sell them to young people. With more than 5 million being thrown away every week, disposable vapes are also damaging our planet. We are acting now to protect our children and our planet. We are looking at banning child-friendly flavours, restricting colourful packaging and mandating that vapes are displayed only behind the counter. We are also exploring a ban or a restriction on disposable vape sales and empowering local authorities to dish out on-the-spot fines for selling vapes to children. All these proposals are being developed with parents and teachers across the UK, and they will strike a balance between giving adult smokers a choice to switch to vaping and preventing our children from taking it up.I recognise the disappointment that the mental health Bill was not included in the King’s Speech, but I can assure hon. Members that this Government are committed to achieving genuine parity between mental health and physical health, improving the care of those detained under the Mental Health Act 1983 and bringing forward the Bill when parliamentary time allows.
- One of the biggest issues raised by every school I visit in my constituency is mental health support, and I am disappointed not to see the mental health Bill in the King’s Speech. Will it be addressed in any other way? Where is it?
- As I said a moment ago—let me remind the hon. Lady of this—we are not waiting for legislation in order to bring forward mental health reforms. That is why, for instance, we have already been rolling out mental health support teams in schools. We are already ahead of schedule on that; we are giving a quarter of England’s school and college children access to mental health support teams a year ahead of schedule. In addition, thanks to this Government, dormitory accommodation for mental health patients will soon become a thing of the past.It has been a pleasure to work with the new Secretary of State for Environment, Food and Rural Affairs, my right hon. Friend the Member for North East Cambridgeshire (Steve Barclay), and a huge honour to work with my hon. Friends the Members for Colchester (Will Quince) and for Harborough (Neil O'Brien) as part of a Government taking the long-term decisions to build a health and care system for the future, one with more doctors, nurses, pharmacists, physios and care workers, better mental healthcare for adults and children, more proactive care in the community, greater capacity, the newest technology and more choice, where conditions are diagnosed quicker or prevented altogether, thus helping people to live longer and healthier lives.
- I call the shadow Secretary of State.
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- I congratulate the Minister on being the great survivor of the Department of Health and Social Care. She must surely be due a carriage clock or the long service medal by now. The only long-term decision for a brighter future seems to be that she is still in her place, although she did not offer much of a brighter future.More positively, I see far more than one nervous face on the Government Benches—I see lots of nervous faces among those contemplating the next general election—but one is undoubtedly that of the hon. Member for Uxbridge and South Ruislip (Steve Tuckwell). I congratulate him on his election and wish him well for his maiden speech, which I can confidently say will be the best speech we hear from those on the Conservative Benches all day.At a time when patients cannot get a doctor’s appointment, families are struggling to pay the mortgage and major conflicts are having an impact on our economy and security, the Prime Minister has spent the past five days deciding whether to sack his Home Secretary for publicly disobeying him, undermining the police and inflaming tensions on our streets. Finally, having had the sheer poor judgment to have appointed someone to such high office when she had already been forced to resign for a serious national security leak, he has summoned up the guts to sack the worst Home Secretary in history. Yet, as we see, the merry-go-round of the Conservative clown show continues. After 13 years, the Conservatives have run out of names at the bottom of the barrel, so they are starting all over again. May I offer my sympathies to the Conservative Members who did not get the call from No. 10 today? What kind of message does it send to their constituents that their own party leader cannot find a suitable candidate for Foreign Secretary among the 350 Conservative MPs who sit in this House?The arsonist has today returned to the fire, because when it comes to the national health service, Lord Cameron has quite a lot to answer for as the architect of austerity and the biggest top-down reorganisation in the history of the NHS—a £3 billion disaster that has led straight to the biggest crisis in the history of the NHS. That is before we even begin to take into account his record of ushering in the “golden” age between Britain and China; taking 20,000 police officers off our streets; and having food bank Britain leave more than 1 million people dependent on charity to feed themselves and their families. That is Lord Cameron’s legacy and as the current Prime Minister admits, “some mistakes were made”. Who is he trying to kid when he tells us that this recycled Conservative Government offer the change our country needs?
- My hon. Friend is absolutely right about that list of failures—it is shocking. I would like to add to the list that over 2,000 autistic people or people with learning disabilities are detained in inappropriate units, when this Government promised over 10 years ago to close them all down.
- I thank my hon. Friend for her intervention. As I make progress through my speech I will come back to the breath-taking complacency about mental health we heard from the Minister a moment ago.Given the scale of the crisis and given that the Prime Minister has made fixing waiting lists one his five priorities, hon. Members might have expected something in the King’s Speech to deal with it. Instead, we got nothing on the NHS as it heads into its most challenging winter yet and we got nothing on social care, just kicking the can down the road and delaying reforms until after the election. There was nothing on dentistry, despite even Conservative Back Benchers crying out for a rescue plan, and nothing on mental health, despite the Conservative party committing to reform, not just in its last manifesto but in its last two manifestos.It was the longest King’s Speech in almost a decade, with the fewest Bills. Does that not just sum up the modern Conservative party? Plenty of slogans, but no solutions. What we got was a Bill that will not come into effect until after the general election and a sack-the-nurses Bill. On the tobacco and vapes Bill, the question is not whether Labour will support it, but whether the Conservative party will support it. Government Members will remember that I first proposed that smoking ban back in January. I say they will remember, because they made their feelings known in newspapers at the time. They called it “nanny state” and“an attack on ordinary people and their culture”.They accused me of “health fascism”. Well, they can now make their considered and nuanced views known to the new Secretary of State—I am sure she is looking forward to receiving them. It just demonstrates that where Labour leads, the Government follow.The Prime Minister may be too weak to whip his Back Benchers to vote that crucial measure through, but on the Opposition Benches we will put country first and party second. Labour MPs will go through the voting Lobby and make sure that the legislation is passed, so that young people today are even less likely to smoke than they are to vote Conservative.
- Is that it?
- The Minister says, “Is that it?”. It is 700,000 more NHS dentistry appointments than her Government are providing. It is ridiculous. The extent to which Ministers continue to parrot these ridiculous lines is embarrassing. If they want to intervene, make my day. I am perfectly prepared to confront any Member with their own Government’s record. Of course, they do not want to defend the Government’s record; they have a hard enough time doing that on the doorstep.Turning back to His Majesty’s Gracious Speech, there may not have been any Bills for the health service last week, but we did see the white flag being waved on the Prime Minister’s pledge to cut waiting lists. Hospitals received a letter telling them to cut the number of operations and appointments they are aiming to offer this year. At the same time, an extra funding pot was announced, so we are literally paying more and getting less. No wonder the NHS is in such a state. No wonder waiting lists have trebled since 2010. No wonder hundreds of thousands more patients are waiting for treatment today than when the Prime Minister first made his pledge.
- I want to make a plea for those 10,000 young people with cystic fibrosis, who have to take multiple medications and endure daily physiotherapy, blood tests, X-rays, and hospital visits—waiting on many occasions—as part of their normal routine just to stay well. The shadow Secretary of State and the Labour Opposition have given a commitment to endeavour to do better for the NHS. Will he do better for those 10,000 young people who have cystic fibrosis?
- I am very grateful to the hon. Member for his intervention. I am deeply concerned about the situation facing children with cystic fibrosis in particular, given that there is radically life-extending treatment available that offers the hope to those young people not just of longer, happier, healthier lives, but of reduced admissions to hospital. It is right that the National Institute for Health and Care Excellence makes those judgments in a rigorous way, looking at the evidence. I hope that it will be successful in bringing down the price of those drugs by negotiating with the pharmaceutical companies to make sure that we can get affordable drugs to families who desperately need them and are desperately anxious that the announcement they have read about means shorter lives for their children. No family should go through that agony, and I hope that a resolution can be found.The Government and the previous Health Secretary got into the habit of stealing Labour’s policies—I say that not as a complaint, but as an invitation. It is clear that the Government do not have a plan to cut NHS waiting lists, but we do: £1.1 billion will be paid straight into the pockets of hard-pressed NHS staff to deliver 2 million more appointments a year at evenings and weekends, paid for by abolishing the non-dom tax status, because patients need treatment more than the wealthiest need a tax break—[Interruption.] Conservative Members groan when we mention charging non-doms their fair share, they groan when we talk about closing private equity loopholes and they groan when we talk about taxing private schools fairly. They did not groan when taxes went up on working people. They did not groan when benefits were cut for the poorest people.We know who the Conservatives are in it for. They are in it for the few; we champion the interests of the many. That is the Labour difference. We believe strongly that people who live or work in Britain should pay their taxes here too. There is still time for the new Secretary of State to lobby the Chancellor ahead of the autumn statement. This genuinely is an oven-ready plan, unlike some of the plans we have heard from the Conservatives, and I encourage the new Secretary of State to nick it.
- We come now to a maiden speech, so there will be no interruptions. I call Steve Tuckwell.
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